Special Contribution from Paul Belcher, EU Government Affairs Advisor for the Royal College of Physicians

Having been a member of the EPHA staff in the ’early days’, Paul Belcher was asked to reflect upon his time working at EPHA and give his opinion of the way in which EPHA has progressed in its role as an alliance for public health advocacy. We also asked him, in his capacity as a member representing a national organisation, to give a potrait of that membership and comment upon the benefits that EPHA provides for its members.


1. Can you give us an insight into what it was like working for EPHA when it had just been set up, fifteen years ago, and there was no established role for EPHA in Brussels. The Secretariat has not grown much physically, but have you observed a growth in EPHA’s stature and position in Brussels?

I arrived in 1994 at an exciting time.

Article 129, the first formal EU Public Health Competence, had been agreed the previous year at Maastricht and EPHA had just been born, with few other health NGOs around in Brussels. There was a real sense of opportunity but also a lot of catching up to do when compared to our colleagues in the environmental or consumer sectors.

However, in these early days our enthusiasm was not matched by resources. We were only two people in EPHA’s first small office, myself as the first Information Officer and an Office Manager/Secretary, plus the wise and guiding hand of Andrews Hayes down the corridor who headed the European Cancer Leagues Office.

Andrew and other committed public health advocates such as Mike Joffe (first EPHA President) had rightly spotted a gap in the NGO community to maximize the new potential for EU public health and EPHA’s position and stature in Brussels grew rapidly from the very start.

A succession of curious EU officials began passing through our office, such as a youthful Bernie Merkel in my first week of work in March 1995, and we achieved early recognition of EPHA’s value to the European Parliament when MEPs invited EPHA to provide the Secretariat for the Health Intergroup.

As new health organizations arrived on the Brussels scene, many of them joined EPHA and there was a strong sense of collaboration rather than competition. Today, its membership is quite remarkable both in number and diversity, and its status as a network of networks, as well as individual member organizations, has enhanced its stature considerably I believe in the many EU fora in which EPHA is invited to join.

2. Looking back over the fifteen years, the monthly newsletter has grown to become one of the most widely-read publications in Brussels. How did it start out and what were the topics you focussed on?

How did it start? I don’t think the truth has ever been revealed to readers before. It was not the high-tech, web-based editorial operation that some readers might have imagined.

I started the newsletter “Update” on a friend’s second hand lap top on a kitchen table in a student flat in Ixelles where I Iived. We only had one computer in the EPHA office and no email or internet to gather information, so I photocopied the news from as many reports and official documents I could find on frequent trips to the EU institutions (when access was much easier) and then took the pile home to write and format on my friends computer.

Aside from the practical problems, I recall the limitations of both the laptop’s word check function and my own editorial experience which sometimes had potentially controversial consequences for EPHA. Our coverage of sensitive European Parliamentary debates on Genetically Modified Orgasms in 1995 was a particularly memorable example, which brought a tear to the eyes of many MEPs I am sure.

Despite the limitations, from the very beginning we tried hard to cover all health impacting activities across the European institutions and not confine ourselves to the embryonic public health activities of DGV (which was later rolled into DG SANCO) and Article 129 on public health.

We tried to delve deep and “uncover” EU activities and policies that had not been challenged by health considerations before. One such issue was EU development aid provided for tobacco production in Zambia, which was ruining the local soil as well as people’s health yet appeared to have gone unnoticed. This theme of integrating health into all other policies, which has since become so fundamental, was a key feature of EPHA’s work from the beginning and was very much reflected in all our activities.

3. In the growing world of advocacy, what has EPHA offered over the years and what are its main achievements in your opinion?

I have seen EPHA from many perspectives, on the inside as an employee, from the outside in the European Parliament, at LSE-Eurohealth and the European Health Management Association, and now as the representative of a large member organization. In all these phases I have valued the consistency that EPHA has brought to a fast changing policy environment with its enduring focus on health related EU policies from the perspective of the individual citizen (whether a healthy citizen or a sick patient); a commitment to reaching out and involving a very broad church of health NGOs and organizations with shared values as a leading voice for public health in Brussels; and the provision of clear information and political signposting to empower individual member organizations to lobby for their own specific goals while providing an important umbrella to unite on shared issues.

EPHA has clearly been involved in many of the discussions and lobbying over the last 15 years that have seen a limited Article 129 grow into a much wider area of EU health and healthcare activity, but I recall particularly the difficult years of persistent but ultimately successful lobbying for a tobacco advertising ban which united EPHA members and colleagues from the cancer and tobacco communities in a formidable coalition.

Success is often long term in Brussels and some of the campaigns are still ongoing today with, I am pleased to say, EPHA continuing to play a lead role. Indeed, it is interesting to look back at news items in the 1995 EPHA newsletter and find headlines curiously similar to those of today which still concern EPHA, “Discussion of EU Health Budget Cuts” “Smoking in Public Places” “Battle over Alcohol labeling” “Concern over Patients Rights to Cross Border Care”. Success in these areas requires persistent dedication and leadership which EPHA’s now long history has enabled it to pursue, and through a tradition of strong Secretary-General Advocates such as Tamsin Rose, and now under Monika’s leadership into the future.

4. Now that you are a member of EPHA representing a national organisation, could you give us a portrait of that membership and what is the benefit of EPHA membership for your organisation?

Being a single national organization which focuses on one specific community (physicians), membership of the EPHA family enables us to extend our own health policy priorities both beyond the UK and across a — wide variety of health organisations and professions throughout Europe. It also enables us to play a direct role in EU discussions, such as our EPHA inspired opportunities to address the European Parliament on nutrition and quality of healthcare, which might otherwise not be possible as a single national organisation.

Networking with other EPHA members is invaluable and the thematic Working Groups established by the EPHA Secretariat provide focused opportunities for us to share information with European colleagues and coordinate lobbying on issues of mutual concern, such as the current discussion about rights to cross-border healthcare. The Policy Coordination Meeting can also provide real opportunities to input directly into shaping wider EPHA policy priorities and support the Secretariat’s advocacy work in Brussels.

In a nutshell, EPHA provides us with not only a wide range of information on what is happening in Brussels (as many organizations do these days), but also the opportunities and network built up over 15 years to use this information effectively to achieve our own organizational goals and as part of a wider European coalition on shared issues.

For More Information

Royal College of Physicians

Last modified on January 30 2009.